Introduction

Histiocytic sarcoma is a rare haematologic entity not sarcoma. Occurs in the Bernese Mountain Dog.

Material and methods

A 74-year-old patient was referred to us from a regional hospital due to oropharyngeal cancer with neck metastasis. The medical history included hot potatoe voice and foetor ex ore for 2 weeks, increasing dyspnea with light exertion and reduced general condition with loss of appetite and weight loss of 10 kilos in the last 4 weeks. The tonsile left was more red than on the right with ulceration and on the outer neck was mass level III palpable. At the same time, there was also a tumor on the back. Several pathologies were diagnosed during staging. The left palatine tonsil was enlarged 4x5x3cm with an inhomogeneous pathological structure with contrast enhancement. At the level of the lesion, ventral to the jugular vein, a 2cm large lymph node. The CT chest showed a 10x7cm soft tissue structure. The CT abdomen showed a 2cm solid mass of the adrenal gland on the bilateral side, a 10cm pathological wall thickening of the sigmoid colon and a 15x9cm soft tissue lesion on the right lumbar paravertebral side. In the skull MRI, a 1cm lesion was detected on the right parietal area. This was followed by biopsies of the tonsil and the lumbar tumor. Histological picture of a rapid growing tumor with necrosis. All leasons had a consistent histological pattern. The largest biopsy was the debulked oropharyngeal mass, identified as hystiocytic sarcoma.

Result

After presentation to the tumor board, chemotherapy with Caelyx was started. The Patient died after 2 Months.

Conclusion

This rare tumor entity with unusual spread presented an interdisciplinary challenge for everyone involved in the diagnosis.

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